Release & Waiver & Authorization for Medical Treatment

RELEASE AND WAIVER AND AUTHORIZATION FOR MEDICAL TREATMENT

EXONERACIÓN, RENUNCIA Y AUTORIZACIÓN PARA TRATAMIENTO MÉDICO

Your Email Address:
(Correo electrónico): *

Today's Date:
(El día de hoy): *

Are you completing this waiver for an adult (over 18 years of age) or for a child (18 and under)?
(¿Está usted completando este documento de renuncia para un adulto de (18 de edad) o para un niño/a (menor de 18 años)?) *

I am attending this event and completing this form for myself (Adult, Over 18)

I am completing this for my student (Minor, 18 and Under)

Select the event on your campus that you or your child will be attending:
(Seleccione el Evento al que asistirá) *

Please select your preferred language:
(Seleccione su idioma preferido.) *

English

Spanish

Would you like a printer friendly copy of this document sent to you via an email upon completion?
(¿Desea una copia para imprimir de este documento que se le envió a través de un correo electrónico al finalizar?) *

Yes

No